Doctor's Advice: Finding the right 'rhythm'

Q Doc, I have been told that a girl can rely on something called the rhythm method to protect herself from pregnancy. My friend says that it would be OK for me to 'go all the way' with a boy, provided that I avoid a certain time of the month.

She is not exactly sure about which time of the cycle I have to avoid. But she says that if I could find out what my 'danger dates' are, then I would be able to have sex all the rest of the time.

Is she correct about this?

A I notice that your friend seems to be keen for you to try this out. She doesn't appear to be employing the rhythm method herself. So could be that she wants to see how you get on before she attempts it.

Now it is true that there is a widespread type of contraception known as the rhythm method. Unfortunately, it is not too effective, particularly as young people are very liable to get mixed up and have sex on the wrong days of the month. Result: pregnancy!

However, I cannot deny that if an intelligent and well-motivated young couple use the rhythm method carefully, it is certainly better than using nothing at all. So I will now explain the basics of it.

First, your menses must be dead regular. You should not even think about the rhythm method if you have irregular periods.

Second, in all calculations to do with the rhythm method, you must count from the first day of the menses. Young women often make the mistake of trying to count from the last day of the period, which simply will not work.

So call the first day of your menses day one. If you have a 28-day cycle, then it is likely that you will ovulate (that is, produce an ovum or egg) round about day 10 to 14. Incidentally, if you don't have a 28-day cycle (for instance, if you have a 30-day or 32-day cycle), that makes life rather more complicated, and therefore you should seek individual advice from a doctor.

Let us assume that your 'danger time' is around days 10 to 14 of your cycle. For safety's sake, you should allow a few 'no sex' days on either side of this. Therefore, women who use the rhythm method will generally make sure that they avoid intercourse between days eight and 17 of the cycle.

Having a 'no sex' rule between days eight and 17 is certainly not 100 per cent effective, but it does cut down substantially on the risks of pregnancy. Alas, using this method is not always easy, because:

Sudden slight irregularities in the menstrual cycle are common, so that a girl may unexpectedly ovulate late or early;

When you are in bed with a guy, and feeling full of passion, it can be very difficult to work out the 'arithmetic' of your menstrual cycle.

My own view is that couples should not rely on the rhythm method unless they have some professional help from a doctor or nurse. Doctors who are interested in contraception can teach you a better version of rhythm called the temperature method.

The idea of this is that you take your temperature every day of the year, and plot it on a chart. Usually, a pattern will emerge in which the reading drops slightly, and then 'kicks' upwards. This indicates the time of ovulation fairly accurately.

In addition, there is a more sophisticated way of identifying your 'danger time'. This is called the Billings method, and it is based on making a daily record of the nature of your vaginal secretions - like whether they are clear, stretchy, slippery, cloudy and so on. A woman who has been trained in the Billings method can usually detect her fertile days fairly accurately.

Because the Billings technique is approved by the Roman Catholic Church, it is usually taught by nurses or doctors who are Catholics. You can get more information by googling the word Billings.

Summing up, the rhythm method is certainly better than taking no precautions at all.

Q Greetings. I am a guy of 19. Last night, I had sex for the first time in my life. To my alarm, I now find that my male organ is sore.

Does this indicate a sexually transmitted infection (STI), Doc?

A No, it doesn't. That is not a symptom of an STI.

In fact, it is extremely common for the penile skin to be sore for a day or two after unaccustomed sexual activity. So it is likely that this soreness will gradually disappear within a very short time.

If you are going to continue having sex, please make sure that it is the safe variety. Always use a condom.

Q I am thinking of becoming pregnant next month. How do you work out when the baby will be due?

A You take the date of the first day of your last period. Then you add nine months and one week to it.

Q Doc, there is a slit in my foreskin. Every time it seems to be healing, as soon as I have sex it opens up again.

I am concerned because this has been the case for around 10 months now. Do you think it is an infection?

A No, I do not. Sounds like you have some sort of dry skin problem. You must let a doctor take a look at this. Once he has done so, he should be able to prescribe some cream, which will make everything heal up permanently.

There is just a chance that if the doctor cannot make everything better, you might have to take a circumcision operation.

Q My boyfriend and I have been trying to conceive for the last five months, but have been unsuccessful. He already has a seven-year-old child by another woman.

I have regular menses. And based on the tests I have done, I can say that I ovulate monthly. About three years ago, my doctor did some pelvic examination, and said everything was OK.

Do you think I should get some fertility testing done now?

A Well, you have had one or two tests already. I would suggest that your boyfriend now has a sperm count done.

I appreciate that seven years ago he was a babyfather. But since then, some health problem may have affected his fertility.

If the sperm count turns out to be OK, then I think that you should indeed have some tests, particularly to find out if the Fallopian tubes are OK. Your doctor's pelvic examination cannot detect whether the tubes are blocked. I wish you good luck.

Q I am a guy of 19, and I am embarrassed to say that I have just caught gonorrhoea. I am being treated.

Just before I started getting the symptoms, I had sex with two girls. How can I tell which of them gave me the disease?

A You cannot. From what you say, it could have been either of them.

The best thing now would be to urge both of them to have tests and treatment.

Email questions to Doc at saturdaylife@gleanerjm.com and read more in the Outlook Magazine tomorrow.